Ovarian cancer starts in the ovaries, which are the glands in women that produce eggs. Upon diagnosis of ovarian cancer, it is surgically staged, which means that the extent and spread of the cancer is determined during surgery. This helps to classify the severity of the disease and guide the treatment and prognosis. Stages run from the least invasive Stage I to the most invasive Stage IV.
Features
Stage III ovarian cancer has several sub-stages: IIIA, IIIB and IIIC, in order of progressing severity. Stage IIIA, described by the American Cancer Society, is diagnosed when cancer can be seen during surgery with the naked eye on one or both ovaries, but no cancer can be grossly seen in the abdomen. Only under a microscope can cancer be seen in abdominal biopsies in this stage, and no cancer is found in the lymph nodes. Stage IIIB involves one or both of the ovaries, and cancer in the abdomen is grossly visible during surgery but the tumors are 2 cm or smaller. Again, no lymph node involvement is present. The last sub-stage, Stage IIIC, involves cancer in one or both ovaries, and lymph nodes are cancerous and/or there are tumors larger than 2 cm in the abdomen.
Symptoms
Symptoms of ovarian cancer typically become apparent once the disease is more advanced, but early ovarian cancer may also have symptoms. The Mayo Clinic lists abdominal fullness or bloating, pelvic pain, constipation, frequent urination and pain with intercourse as symptoms. Because these symptoms can be similar to symptoms of other illnesses, it is important to get persistent symptoms evaluated by a health care provider.
Diagnosis
A pelvic exam, ultrasound and CA-125 blood test can all suggest ovarian cancer, but a definitive diagnosis and staging requires a biopsy and surgery. A biopsy of the ovary is typically taken during surgery, according to the American Cancer Society.
Treatment
According to the National Cancer Institute (NCI), treatment for Stage III ovarian cancer typically includes surgery and chemotherapy. Surgery may include removal of the tumor, removal of the uterus and one or both fallopian tubes and ovaries, and removal of the omentum, a fold of abdominal lining. If there is less than 1 cm of cancer remaining after surgery, the NCI recommends chemotherapy, typically combination chemotherapy consisting of more than one cancer drug. Chemotherapy may be given either intravenously or intraperitoneally, in which the chemotherapy is placed into the abdominal cavity through a port. If more than 1 cm of cancer remains, combination chemotherapy and/or clinical trials may be recommended.
Prognosis
The American Cancer Society lists five-year survival rates, taken from the NCI SEER database, and the rates vary according to sub-stage.The five-year survival rates estimate the percentage of individuals who will be alive five years after diagnosis. For Stage IIIA ovarian cancer, the five-year survival rate is 45 percent; Stage IIIB is 39 percent; and Stage IIIC is 35 percent.
